| 许丹霞,陈强,章尧,柴玮璐,张同龙,蒋天安,赵齐羽.超声引导下经皮穿刺活检诊断胰腺实性病变[J].中国医学影像技术,2024,40(4):494~497 |
| 超声引导下经皮穿刺活检诊断胰腺实性病变 |
| Ultrasound-guided percutaneous biopsy for diagnosing solid pancreatic lesions |
| 投稿时间：2023-12-18 修订日期：2024-01-02 |
| DOI：10.13929/j.issn.1003-3289.2024.04.004 |
| 中文关键词: 胰腺肿瘤 超声检查 活组织检查 |
| 英文关键词:pancreatic neoplasms ultrasonography biopsy |
| 基金项目:国家自然科学基金(82171937)。 |
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| 中文摘要: |
| 目的 观察超声引导下经皮穿刺活检诊断胰腺实性病变的效能,探讨诊断准确率影响因素。方法 回顾性分析746例因胰腺实性病变接受经皮超声引导下粗针穿刺活检(US-CNB)患者,记录临床及影像学资料、胰腺穿刺相关资料和病理诊断;以穿刺12个月后临床随访结果为最终诊断,评估US-CNB诊断胰腺实性病变的效能。以单因素分析及logistic回归 分析筛选影响US-CNB诊断准确率的因素。结果 742穿刺活检成功,技术成功率99.46%(742/746)。US-CNB准确诊断706例(准确组)、不准确36例(不准确组),其诊断胰腺实性病变的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为95.25%(702/737)、80.00%(4/5)、95.15%(706/742)、99.86%(702/703)和10.26%(4/39)。31例(31/742,4.18%)发生轻度并发症,4例(4/742,0.54%)发生严重并发症。组间患者年龄,胰腺病灶最大径＜2 cm、病灶边界不清晰及病灶位于胰头部占比差异均有统计学意义(P均＜0.1)。回归分析显示,病灶最大径＜2 cm是US-CNB诊断准确率的独立影响因素(OR=3.054,P=0.030)。结论 超声引导下经皮胰腺病变穿刺活检安全、可靠,但病灶体积小可能影响其准确性。 |
| 英文摘要: |
| Objective To observe diagnostic efficacy of ultrasound-guided percutaneous biopsy for solid pancreatic lesions, also to explore the impact factors of diagnostic accuracy. Methods Data of 746 patients with solid pancreatic lesions underwent ultrasound-guided core needle biopsy (US-CNB) were retrospectively analyzed. Clinical data, imaging records, pancreatic puncture-related information and pathological diagnosis details were collected. After 12 months follow-up, the final clinical diagnoses were assessed, and the efficacy of US-CNB for diagnosing solid pancreatic lesions was evaluated. Univariate analysis and logistic regression analysis were used to screen impact factors for US-CNB diagnostic accuracy of solid pancreatic lesions. Results US-CNB was successfully performed in 742 cases, with the technical success rate of 99.46% (742/746). US-CNB accurately diagnosed pancreatic lesions in 706 cases (accurate group) but inaccurately judged 36 cases (inaccurate group). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of US-CNB for diagnosing solid pancreatic lesions was 95.25% (702/737), 80.00% (4/5), 95.15% (706/742), 99.86% (702/703) and 10.26% (4/39), respectively. Mild post-procedural complications occurred in 31 cases (31/742, 4.18%), while severe complications observed in 4 cases (4/742, 0.54%). There were significant differences of patients' age and the ratio of lesions with the maximum diameter ＜2 cm, with unclear boundaries or located in the head of pancreas between groups (all P＜0.1). Regression analysis showed that the maximum diameter of lesion ＜2 cm was the independent impact factor of the accuracy of US-CNB for diagnosing solid pancreatic lesions (OR=3.054, P=0.030). Conclusion Ultrasound-guided percutaneous biopsy of solid pancreatic lesion was safe and reliable, but its accuracy might decrease in small size lesions. |
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